Reporting and Control of Gastrointestinal and Respiratory Illness Clusters

Each winter, clusters of respiratory and gastrointestinal (GI) illness occur in Massachusetts’ long term care (LTC) and assisted living (AL) facilities. The Massachusetts Department of Public Health (MDPH) Bureau of Infectious Disease and Laboratory Sciences receives an average of 102 reports of GI illness clusters and 147 reports of respiratory illness clusters in these facilities annually, representing considerable illness among residents.

A cluster is defined as an increase in illness above what is expected for your facility with regard to place and time, regardless of any positive or negative laboratory test results.

Clusters of gastrointestinal and respiratory illness in a LTC or AL facility are reportable to public health upon their initial identification, and can be reported using the Gastrointestinal Illness or Influenza/Respiratory Illness Cluster Reporting Forms, found on the MDPH website: http://www.mass.gov/eohhs/gov/departments/dph/programs/id/isis/case-report-forms.html

After your completion and submission of the report to the number listed on the form, an MDPH epidemiologist or the local health department will call you to discuss control measures and ensure that all appropriate notifications have been made. Please submit only one reporting form per cluster. After submitting the initial reporting form, updates to the cluster can be provided over the phone to your contact at the state or local health department.

In the event of a GI illness cluster, an MDPH epidemiologist and the local health department can work with you to arrange for norovirus testing at the Massachusetts State Public Health Laboratory. For respiratory clusters, the MDPH epidemiologist or local health department can help arrange for influenza testing, consideration of antiviral prophylaxis, and other infection control measures.

Guidance on infection control in long term care facilities, including Gastrointestinal Disease and the Control of Influenza and Pneumococcal Disease, can be found on the MDPH website:

Additional reporting forms can be obtained by contacting the MDPH Office of Integrated Surveillance and Informatics Services (ISIS) at (617) 983-6801. Please contact the Epidemiology and Immunization Program with any questions regarding the reporting or investigation of illness clusters by calling (617) 983-6800 or your local health department.